It was the amendment that made the difference between Texas House legislators ending their budget debate at 1:30 a.m. or 5:30 a.m. on Friday morning.

When Rep. Matt Rinaldi, R-Irving, laid out his proposed tweak to an amendment by state Rep. Drew Springer, R-Muenster, that would ban abortion providers from receiving any funds from the state budget, House members had already been in the chamber for more than 12 hours to debate amendments on the proposed two-year state budget. Rinaldi's proposal — technically, an amendment to Springer's amendment — added language that would also exclude affiliates of abortion providers. When Springer accepted the changes, House lawmakers agreed to bypass floor debates on dozens of other amendments and instead insert them into a non-binding portion of the budget known as "the wish list." Springer's amendment passed 101-43, and soon legislators went home.

Rinaldi said he was inspired to propose the amendment after looking at the state comptroller's website and noticing Planned Parenthood affiliates were still receiving state dollars despite being cut out of various state health programs.

He said lawmakers' previous efforts to keep state money from abortion providers did not go far enough because they failed to defund organizations affiliated with such providers. He pointed to how Planned Parenthood affiliates are still able to receive state funding despite operating separate surgical centers to provide abortions. Rinaldi's staffers found that Planned Parenthood of Greater Texas, Planned Parenthood Gulf Coast and Planned Parenthood of Texas Capital Region received more than $500,000 in payments from state agencies in the current two-year budget. Rinaldi said banning abortion providers from all state funding would help close loopholes.

“This is the broadest prohibition Texas has ever passed and certainly the strongest statement against taxpayer-funded abortion,” Rinaldi said.

It's unclear whether the measure will make it into law. House and Senate lawmakers must now reconcile their competing versions of the state budget.

The amendment is part of the Republican-controlled Legislature's long history of budget and state agency maneuvers to defund Planned Parenthood affiliates and other abortion providers. Currently, state officials are also seeking to remove Planned Parenthood from Medicaid, the federal-state health insurance program for low-income people and the disabled. A federal judge blocked the state's efforts earlier this year, but the attorney general's office is appealing the decision. Now that Republicans control both chambers of Congress and the White House, reproductive rights advocates fear Texas and other states may be empowered to take more bolder action to stop abortions. Several anti-abortion bills are moving through both chambers as the session enters its final weeks.

In the 2016 budget year, Planned Parenthood Gulf Coast received $108 from the Department of Assistive and Rehabilitative Services, $12.27 from the attorney general's office and $369,974.83 for a community grant from the Department of State Health Services, according to the state comptroller's website. Meanwhile, Planned Parenthood of Greater Texas received $137,445.46 from the state health services department for a grant and $18 from the assistive and rehabilitative services department. Planned Parenthood of the Texas Capital Region received $36.01 from the Department of Assistive and Rehabilitative Services.

The state comptroller's website does not offer details on what the payments were specifically for, and the state Health and Human Services Commission could not immediately provide that information either.

However, the commission reported paying Planned Parenthood affiliates an estimated $4.4 million in 2016 for a combination of HIV services, breast and cervical cancer screenings and Medicaid reimbursements. Planned Parenthood received $507,000 through the Breast and Cervical Cancer Program; $312,000 for HIV prevention services; and $3.6 million for providing family planning services through Medicaid, including contraceptive services and pregnancy testing.

Planned Parenthood has not been a provider in the breast and cervical cancer program since August 2015; the 2016 payments the state made to the organization as part of that program were for previous services, said commission spokeswoman Carrie Williams. Planned Parenthood has not been a provider in the HIV program since midway through the 2016 budget year, she said.

Sarah Wheat, chief external affairs officer for Planned Parenthood of Greater Texas, said it's unclear how affiliates would be affected.

“I assume his goal is to create new barriers, but we’re not clear yet on how he’s trying to achieve that,” Wheat said of Rinaldi.

Wheat pointed out that state and federal laws already prohibit taxpayer dollars from being spent on abortions. Planned Parenthood abortion services are offered separately from their clinics and made up 3 percent of procedures done in 2015, according to the organization’s latest report.

Rep. Chris Turner of Grand Prairie, chairman of the House Democratic Caucus, said 42 Democrats voted no on Rinaldi’s amendment. Rep. Sarah Davis of West University Place was the sole Republican to vote against Rinaldi's amendment. Turner said the amendment was part of the “long line of misguided, partisan, Republican attacks” on reproductive health.

“It’s absolutely a bad amendment, there’s no question about that,” Turner said. “It’s hard for me in any way to rank the offensive nature of the variety of similar provisions that Republicans have put forward in the last several years.”

Years in the making

Elizabeth Nash, state issues director for the Guttmacher Institute, a reproductive rights advocacy group, said Rinaldi’s amendment would likely curb any direct or indirect payments from going to abortion providers. She said she was unaware of other states going this far in their budgets.

But this kind of budget-wide abortion provider ban was years in the making.

Emily Horne, senior legislative associate for Texas Right to Life, said preventing any funding from going to abortion providers “is the big-picture solution,” beyond previous defunding efforts the state Legislature has tried. She said she doesn’t think this would make a large dent in abortion providers’ pockets right away, but the amendment makes legislators' intent clearer.

“We wanted this to pass for a while,” Horne said. “There have been standalone bills like this before, but I would say that really in 2011 is when this major movement started and it started to be tempting to go toward bigger targets.”

The state has succeeded in recent years with siphoning off funding streams for Planned Parenthood and other abortion providers.

Consider the bitter aftermath of 2011 cuts for family planning program funding from $111.5 million to $37.9 million for the 2012 and 2013 budget years.

Then consider how state legislators decided in 2013 to launchthe Texas Women’s Health Program to replace the Medicaid Women’s Health Program. That allowed them to exclude abortion providers from providing services such as pregnancy tests, STD testing, contraceptive counseling and receiving reimbursements. It also led to the state missing out on federal family planning dollars.

And in 2015, Texas legislators used a budget provision to muscle out abortion providers from receiving millions of dollars in Medicaid reimbursements from the Breast and Cervical Cancer Services program. Later that year, the Texas Department of State Health Services ended Planned Parenthood Gulf Coast's $600,000 contract that provided HIV prevention services.

Rep. Jessica Farrar, D-Houston, chairwoman of the Texas House Women's Health Caucus, said Rinaldi’s amendment is “no less significant from others” to limit access to Planned Parenthood. She said the Healthy Texas Women’s Program — which replaced the Texas Women's Health Program last year — needs more providers to serve patients.

“It’s ridiculous that the Texas Legislature is spending millions of tax dollars trying to re-create a health care delivery system that it has spent so much effort trying to destroy,” she said.

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A high-ranking official at the Texas Health and Human Services Commission is resigning after he co-authored an unflattering study that found the state’s exclusion of Planned Parenthood from a family planning program restricted women’s access to health care.

Amid an ongoing battle over Planned Parenthood’s participation in the state Medicaid program, Texas health officials are cutting off funding to a Planned Parenthood affiliate for an HIV prevention program.

With the exclusion of Planned Parenthood clinics from the Texas Women's Health Program, records show claims for birth control and wellness exams dropped, as did enrollment numbers.

Disclosure: Planned Parenthood has been a financial supporter of The Texas Tribune. A complete list of Tribune donors and sponsors is available here.

Clarification: This story has been updated to make clear that Rinaldi's proposal was an amendment to an amendment by Springer.

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